# The Patient Protection Act Is About To Put $1.3 BILLION Back In Consumers' Pockets **URL:** \ **Category:** Great Debates\ **Created:** [May 12, 2012, 2:19am UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665 "2012-05-12T02:19:13Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [May 12, 2012, 7:35pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/41 "2012-05-12T19:35:29Z")
> [@WillFarnaby](#): > > [http://www.washingtontimes.com/news/2012/mar/27/obamacare-costs-double-in-two-years/](http://www.washingtontimes.com/news/2012/mar/27/obamacare-costs-double-in-two-years/) > > What are the chances we hear this on MSNBC? lol just kidding. Seriously, can’t we all agree this is a bad thing? A better question, is when you read this link, and find out that what you posted isn’t true, will you revise your opinions in an honest fashion? [http://www.nationalreview.com/corner/293932/no-obamacare-s-costs-didn-t-double-patrick-brennan#](http://www.nationalreview.com/corner/293932/no-obamacare-s-costs-didn-t-double-patrick-brennan#) > [@](#): > > This claim, that the CBO’s 2012 estimate suggests Obamacare will cost twice as much as originally projected when the bill was passed in 2010, has been widely trumpeted, by some rather doggedly, as another Obamacare failure, but unfortunately, it’s entirely dishonest accounting, as a range of liberal bloggers have pointed out. > > Here’s why: The gross costs of Obamacare’s insurance coverage in the CBO’s 2010–2019 estimate were indeed $940 billion (table 2, page 2, here). The updated estimate covers the years 2012–2022, in which the gross costs will be $1.76 trillion, which is, yes, almost double the other number (table 2, here). But these numbers aren’t remotely comparable. ---
**Author:** ![Martin\_Hyde](https://avatars.discourse-cdn.com/v4/letter/m/47e85d/32.png) [@Martin\_Hyde](https://boards.straightdope.com/u/Martin_Hyde)\ **Post date:** [May 12, 2012, 10:01pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/42 "2012-05-12T22:01:33Z")
> [@Lobohan](#): > > Dude, it costs 1000 dollars to shine widgets. At the end of the year I get 300 dollars back. Right, which is an interest free loan. > [@](#): > > I should throw that money away, because it’s “an interest free loan?” > > Are you aware how utterly insane that is? Please show where I said anything like that. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [May 12, 2012, 10:20pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/43 "2012-05-12T22:20:23Z")
> [@Martin\_Hyde](#): > > Right, which is an interest free loan. Look, obviously you’re awfully proud of understanding the concept of an interest free loan. > [@](#): > > Please show where I said anything like that. > [@Martin Hyde](#): > > 1. The people who come in and start saying blatantly un-scientific things like “this is $1.3bn savings!!” Savings for who? Even the individual policy holders aren’t really “saving” anything, they instead actually made an interest free loan to their insurance company. Due to the time value of money they actually lost money on the deal. > [@Martin Hyde](#): > > So the truth is “negative spin.” Are you one of those people that gets really excited when the IRS gives you a fat rebate check? Unless that check is due to some tax credits that actually give you back more money than you paid in, the larger the rebate check the less money you had throughout the year and the more money you were lending to the government at 0% interest. What those two posts say to me, is that you seem to think getting money back is worthless unless you make interest on it. That is, of course, utter and complete nonsense. You are saying\* utter and complete nonsense\* because you want to negatively paint the ACA as somehow shitty (I assume). If you are stating _utter and complete nonsense_ for some other reason, let me know. One more time, in the hopes you’ll get it: I paid a thousand dollars to have my widgets shined. At the end of the year I got a rebate of three hundred dollars.(because of the govt. rules on widget washers) You are dismissively calling the rebate an interest free loan. You’re doing that, I assume because you have a need to cast the ACA as sinister. And yes, I understand what you mean by interest free. It’s just stupid. You got money back. You are better off than you would have been. Only a complete partisan hack would spit and fidget about how they got no interest on the rebate. ---
**Author:** ![colonial](https://avatars.discourse-cdn.com/v4/letter/c/34f0e0/32.png) [@colonial](https://boards.straightdope.com/u/colonial)\ **Post date:** [May 12, 2012, 10:40pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/44 "2012-05-12T22:40:45Z")
> [@Shayna](#): > > _"We aren’t exactly out of “the fog of controversy” that then-Speaker Nancy Pelosi said we’d have to be out of before we could see the benefits of the Patient Protection and Affordable Care Act, but we’re about to see just how right she was. … to the tune of $1.3 billion that will go back into healthcare consumers’ pockets because of the 80/20 rule written into the law. That’s $1.3 billion that can be used to save people’s homes. $1.3 billion that can help put food on empty tables. $1.3 billion that can put gas in people’s cars so they can get to job interviews, that can buy clothes for kids who’ve outgrown them, that can purchase much-needed school supplies, that can be set aside for retirement._ > > _That’s $1.3 billion that will be going back into our economy, helping lift us further out of the recession we’ve barely been scraping our way out of—because Republicans in Congress blocked every effort by President Obama to put people back to work. It’s $1.3 billion that was supposed to be used on patient health care … and wasn’t!"_ > > [http://www.winningwordsproject.com/the\_patient\_protection\_act\_is\_about\_to\_put\_1\_3\_billion\_back\_in\_consumers\_pockets](http://www.winningwordsproject.com/the_patient_protection_act_is_about_to_put_1_3_billion_back_in_consumers_pockets) > > What are the chances we’ll hear about this on Fox News? LOL Just kidding. Seriously, though, can we not at least all agree that this is a good thing? > > Discuss. Discuss? Sure, how about woopdeeshit? Please study the following numbers: $1.3 billion = ~$4 per capita. National annual medical spending = ~$8000 per capita. My yearly medical & dental isurance premiums = $4071.84 ($5000 copay on medical) My 2011 medical & dental out-of-pocket expenses = $547.32 In case you missed it the first time, that was “woopdeeshit”. ---
**Author:** ![WillFarnaby](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/willfarnaby/32/514_2.png) [@WillFarnaby](https://boards.straightdope.com/u/WillFarnaby)\ **Post date:** [May 12, 2012, 10:59pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/45 "2012-05-12T22:59:33Z")
> [@Lobohan](#): > > A better question, is when you read this link, and find out that what you posted isn’t true, will you revise your opinions in an honest fashion? > > [http://www.nationalreview.com/corner/293932/no-obamacare-s-costs-didn-t-double-patrick-brennan#](http://www.nationalreview.com/corner/293932/no-obamacare-s-costs-didn-t-double-patrick-brennan#) It makes me feel so much better that instead of costing 900 billion between 2010 and 2019, it’s costing 1.76 trillion between 2012 and 2022. Since the author claims these numbers aren’t comparable I guess I shouldn’t compare them. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [May 12, 2012, 11:04pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/46 "2012-05-12T23:04:08Z")
> [@WillFarnaby](#): > > It makes me feel so much better that instead of costing 900 billion between 2010 and 2019, it’s costing 1.76 trillion between 2012 and 2022. Since the author claims these numbers aren’t comparable I guess I shouldn’t compare them. Read the whole article, why not? ---
**Author:** ![Shayna](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/shayna/32/17976_2.png) [@Shayna](https://boards.straightdope.com/u/Shayna)\ **Post date:** [May 12, 2012, 11:14pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/47 "2012-05-12T23:14:05Z")
> [@Lobohan](#): > > What are you specifically arguing against? Specifically? [Not the person he should have been arguing against.](http://boards.straightdope.com/sdmb/showthread.php?p=15058330#post15058330) ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 13, 2012, 2:41am UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/48 "2012-05-13T02:41:51Z")
Here’s a link to the author you quoted in your OP: [http://www.winningwordsproject.com/jillwklausen](http://www.winningwordsproject.com/jillwklausen) Was it her “Women For Obama” sticker that made you think she is conservative? And here’s a link to a memo sent by Mark Halperin in his capacity as ABC News Director. [http://www.freerepublic.com/focus/f-news/1713443/posts](http://www.freerepublic.com/focus/f-news/1713443/posts) The memo tells ABC reporters to not hold Democrats and Republicans equally accountable, because although Kerry lies, and distorts, those aren’t central to his efforts to win. In my opinion, it is a blatant lie to call Mark Halperin a conservative columnist. So, in short, shut up. You are not dumb, but you can’t see past your highly polarized glasses. If you want to know what the law says, read the law, not what an advocate for the law tells you. And if you’re reading Mark Halperin and telling yourself that’s the conservative view you’re getting, I think I see the problem. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 13, 2012, 2:50am UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/49 "2012-05-13T02:50:58Z")
Huh. The above post was intended for the Pit thread, and the polite version in the Pit thread was intended for here. Sorry about that. ---
**Author:** ![HeathnFarmer](https://avatars.discourse-cdn.com/v4/letter/h/8e7dd6/32.png) [@HeathnFarmer](https://boards.straightdope.com/u/HeathnFarmer)\ **Post date:** [May 13, 2012, 3:06am UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/50 "2012-05-13T03:06:53Z")
> [@colonial](#): > > $1.3 billion = ~$4 per capita. > > “woopdeeshit”. I gather you missed the bit about only 16m people getting a rebate. If you’re one of the lucky and don’t want the 80 bucks, I’ll take it. And as mentioned, the point of this is to require that insurance companies spend 80% of premium dollars on patient care. The other is profit and overhead. Sounds more than fair to me. My insurer has an overhead of 5%. ---
**Author:** ![colonial](https://avatars.discourse-cdn.com/v4/letter/c/34f0e0/32.png) [@colonial](https://boards.straightdope.com/u/colonial)\ **Post date:** [May 13, 2012, 4:26am UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/51 "2012-05-13T04:26:59Z")
> [@HeathnFarmer](#): > > I gather you missed the bit about only 16m people getting a rebate. If you’re one of the lucky and don’t want the 80 bucks, I’ll take it. > > And as mentioned, the point of this is to require that insurance companies spend 80% of premium dollars on patient care. The other is profit and overhead. Sounds more than fair to me. My insurer has an overhead of 5%. You are right, I did miss the $80 part. But I am also still right- $80 is so trivial an amount that it is not worth bragging about, and cute little rhetorical devices such as offering to take the $80 from anyone who does not want it is not going to increase its value. Although the 80% requirement sounds like it should have some long-term potential it will have to amount to a hell of a lot more than $80 to get any applause from me. ---
**Author:** ![tomndebb](https://avatars.discourse-cdn.com/v4/letter/t/b9e5f3/32.png) [@tomndebb](https://boards.straightdope.com/u/tomndebb)\ **Post date:** [May 13, 2012, 6:07am UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/52 "2012-05-13T06:07:57Z")
> [@Bricker](#): > > Huh. The above post was intended for the Pit thread, and the polite version in the Pit thread was intended for here. > > Sorry about that. Posters are already way too worked up on this issue without getting posts in the wrong fora. Let’s make a concerted effort to keep the insulting comments to The BBQ Pit. [/Moderating] ---
**Author:** ![What\_the](https://avatars.discourse-cdn.com/v4/letter/w/f4b2a3/32.png) [@What\_the](https://boards.straightdope.com/u/What_the)\ **Post date:** [May 13, 2012, 1:57pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/53 "2012-05-13T13:57:56Z")
> [@colonial](#): > > Discuss? > > Sure, how about woopdeeshit? > > Please study the following numbers: > > $1.3 billion = ~$4 per capita. > > National annual medical spending = ~$8000 per capita. > > My yearly medical & dental isurance premiums = $4071.84 ($5000 copay on medical) > > My 2011 medical & dental out-of-pocket expenses = $547.32 > > In case you missed it the first time, that was “woopdeeshit”. Yabut, see, Obama did it… that’s the key thing. ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [May 13, 2012, 3:30pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/54 "2012-05-13T15:30:25Z")
> [@colonial](#): > > You are right, I did miss the $80 part. > > But I am also still right- $80 is so trivial an amount that it is not worth > bragging about, and cute little rhetorical devices such as offering to > take the $80 from anyone who does not want it is not going to increase > its value. > > Although the 80% requirement sounds like it should have some long-term > potential it will have to amount to a hell of a lot more than $80 to get > any applause from me. So… Will you use the same line of reasoning if taxes go up $80 per person? Will you tell us not to worry because $80 is a trivial amount? Will you say an $80 tax increase would have to amount to a hell of a lot more before you get upset about it? ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [May 13, 2012, 3:50pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/55 "2012-05-13T15:50:56Z")
> [@Euphonious\_Polemic](#): > > So… Will you use the same line of reasoning if taxes go up $80 per person? Will you tell us not to worry because $80 is a trivial amount? Will you say an $80 tax increase would have to amount to a hell of a lot more before you get upset about it? In practical human terms, a small negative is not the same as a small positive of equal magnitude. ---
**Author:** ![colonial](https://avatars.discourse-cdn.com/v4/letter/c/34f0e0/32.png) [@colonial](https://boards.straightdope.com/u/colonial)\ **Post date:** [May 13, 2012, 4:38pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/56 "2012-05-13T16:38:06Z")
> [@Euphonious\_Polemic](#): > > So… Will you use the same line of reasoning if taxes go up $80 per person? Yes. > [@Euphonious\_Polemic](#): > > Will you tell us not to worry because $80 is a trivial amount? Yes. > [@Euphonious\_Polemic](#): > > Will you say an $80 tax increase would have to amount to a hell of a lot more before you get upset about it? Yes. ---
**Author:** ![Buck\_Godot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/buck_godot/32/6573_2.png) [@Buck\_Godot](https://boards.straightdope.com/u/Buck_Godot)\ **Post date:** [May 14, 2012, 5:11pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/57 "2012-05-14T17:11:13Z")
> [@colonial](#): > > Although the 80% requirement sounds like it should have some long-term > potential it will have to amount to a hell of a lot more than $80 to get > any applause from me. Even though it is about 4 times the amount of money the government spends on planned parent hood, 5 times the amount of federal funding that goes to public broadcasting, 10 times the amount of funding for the national endowment for the arts? Personally I would be willing to call it a drop in the bucket, if the conservatives would quit whining about the spending on these programs. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [May 14, 2012, 5:42pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/58 "2012-05-14T17:42:03Z")
> [@Shayna](#): > > What are the chances we’ll hear about this on Fox News? LOL Actually that won’t be necessary. Just to head off the possibility that this doesn’t get off enough publicity, the feds issued regulations that anyone who receives a refund check has to be notified by the insurance company that this check was issued as part of the HCR law. Of course, that only covers those who receive refund checks. But what about the vast majority who will not be receiving refund checks? How will they know about the great HCR law? Not to worry. The feds enacted regulations that the insurance companies are required to notify anyone who does not get a refund check that this is because their insurance company is in compliance with HCR. (But only for 2011, which is what really counts, what with the election being in 2012.) [http://www.ofr.gov/(X(1)S(jjrs4ed5kzxdimcuodok0zn3)](http://www.ofr.gov/(X(1)S(jjrs4ed5kzxdimcuodok0zn3)))/OFRUpload/OFRData/2012-11753\_PI.pdf (Page 26) So all is OK. You can breathe easy now. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [May 14, 2012, 5:48pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/59 "2012-05-14T17:48:01Z")
> [@Martin\_Hyde](#): > > The point is that insurance companies will get better at classifying non-medical expenses as medical expenses? I doubt that. Actually, what will happen is that certain admin items that are currently included with the policy will be removed and treated as being outside of it. This is going to happen with insurance agent fees, and any number of other items will be similarly restructured. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [May 14, 2012, 8:38pm UTC](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665/60 "2012-05-14T20:38:50Z")
> [@Martin\_Hyde](#): > > The point is that insurance companies will get better at classifying non-medical expenses as medical expenses? I doubt that. Unless you think we’ve got our first fraud and abuse proof government program in history, of course. So now insurance companies are going to engage in widespread fraud and abuse? > [@Martin\_Hyde](#): > > While it’s been alluded to above that $1.5bn is basically no money at all (even the shittiest Federal government agencies have budgets multiple times that amount), to put it in perspective the health insurance industry in the United States in an $850 billion industry. To put it in perspective, the SEC has a budget of 1.2 billion and the CFTC is only 200 million. Lots of other cshitty government agencies that have budgets under 1.5 billion. Or did you not mean for that to be a factual statement? > [@Martin\_Hyde](#): > > Maybe we can use the $1.3bn to replace some of the $14bn cost to us taxpayers to bail out lazy union auto workers in Michigan, that gets us close to breaking even…right? I think you are mischaracterizing the auto bailouts under Obama and the results therefrom. Or are you talking about the bailouts under Bush? > [@elucidator](#): > > Is there something onerous and difficult about insurance at a mere 20 percent profit? Whatever happened to the magic of competition, the Invisible Finger? 20% is not profit, its an 80% medical loss ration. IOW 80% of the money of the money has to go to paying medical costs; that does not include stuff like sales commissions, taxes, salaries, overhead and a bunch of other stuff. As a comparison, medicare’s medical loss ratio is in excess of 98%. > [@Shodan](#): > > Shayna, your blogger is either lying or stupid - > It was never out of the economy, and anyone with even a nodding acquaintance with economics knows it. > > What does this stupid blogger think, that it was buried in the back yard someplace? You mean like how taxes are never out of the economy? > [@Martin\_Hyde](#): > > Insurance company dollars just fly away into a black hole and never get spent on anything else? Insurance companies don’t pay money back out to shareholders or employees as wages that end up getting spent? Insurance companies don’t have to act as consumers when they buy all the shit any company needs to run? Just like how taxes just fly away into a black hole and never get spent on anything else. Governments don’t pay interest on their debt or to their employees as wages that end up getting spent? Governments don’t have to act as consumers when they buy all the shit that they need to operate. > [@](#): > > This is just part and parcel of the deep economic ignorance from the left on these boards. **Insurance companies are consumers too**. You guys always grasp the thinnest threads of understanding the economy, but it shows you lack a true understanding because you fail to recognize the vast interconnected nature of the real market, and instead try to break it down into simplistic concepts like “consumers = Ma and Pa Kettle but not Joe Health Insurance Company.” This is just part and parcel of the hypocritical economic ignorance from the righton these baords. **governments are consumers too**. You guys always grasp the thinnest threads of understanding the econnomy, but it shows you lack a true understanding because you fail to realize the…blah blah blah > [@Martin\_Hyde](#): > > So the truth is “negative spin.” Are you one of those people that gets really excited when the IRS gives you a fat rebate check? Unless that check is due to some tax credits that actually give you back more money than you paid in, the larger the rebate check the less money you had throughout the year and the more money you were lending to the government at 0% interest. So without the medical loss ratio rule these insurance companies were going to give their customers a reabate anyways? or are we talking about money that people would not have received BUT FOR the new medical loss ratio rule. For someone who claims all sorts of competence on economics, you seem to have a really wierd concept of what constitutes a loan. > [@](#): > > During the year the insurance company had that money on their books, I’m willing to bet they made money from it. And they would have made even more if they didn’t have to pay the rebates back to their customers. > [@Martin\_Hyde](#): > > Right, which is an interest free loan. Not really. > [@Fotheringay-Phipps](#): > > Actually, what will happen is that certain admin items that are currently included with the policy will be removed and treated as being outside of it. > > This is going to happen with insurance agent fees, and any number of other items will be similarly restructured. The medical loss ratio is (medical losses/gross premiums). We have a pretty good idea of what cosntitutes “medical losses” and its proven very difficult to increase the size of the numerator so yes, there is some focus on reducing the size of the denominator but its not anywhere as simple as creating a separate line item for sales commissions, those items will probably still be considered “gross premiums” [Previous page](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665.md?page=2) [Next page](https://boards.straightdope.com/t/the-patient-protection-act-is-about-to-put-1-3-billion-back-in-consumers-pockets/621665.md?page=4)